Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL 60201, USA.
Semin Fetal Neonatal Med. 2012 Feb;17(1):12-9. doi: 10.1016/j.siny.2011.09.001. Epub 2011 Sep 25.
Preterm labor is defined as labor that begins before 37 completed weeks of pregnancy. More than 12% of infants born in the USA are preterm. At least 40% of preterm births are associated with intrauterine infection. Toll-like receptors (TLRs) are members of a family of cell-surface proteins responsible for recognition of a diverse spectrum of bacterial, viral and fungal pathogens. TLRs initiate the host innate (i.e. non-adaptive) immune response, inducing a proinflammatory cascade involving cytokines, chemokines, prostaglandins, and other effector molecules that result in the characteristic phenomena of labor, such as uterine contractions and rupture of fetal membranes. These cascades may also be activated by mechanisms that are not primarily infectious but are accompanied by inflammatory responses. Now that the molecular mechanisms linking infection and labor have been, to a large extent, elucidated, the challenge is to identify points of overlap with non-infectious causes of labor and to find intervention strategies that can minimize the negative impact of preterm delivery.
早产是指妊娠 37 周前开始的分娩。美国超过 12%的婴儿是早产儿。至少 40%的早产与宫内感染有关。Toll 样受体 (TLR) 是细胞表面蛋白家族的成员，负责识别多种细菌、病毒和真菌病原体。TLR 启动宿主固有（即非适应性）免疫反应，诱导涉及细胞因子、趋化因子、前列腺素和其他效应分子的促炎级联反应，导致分娩的特征现象，如子宫收缩和胎膜破裂。这些级联反应也可能通过不是主要感染但伴有炎症反应的机制激活。既然感染和分娩之间的分子机制在很大程度上已经阐明，那么挑战就是要确定与非感染性分娩原因的重叠点，并找到可以最大限度减少早产负面影响的干预策略。
